Healthcare Provider Details

I. General information

NPI: 1659360592
Provider Name (Legal Business Name): BRIAN EASTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13198 JAMES MADISON HWY
ORANGE VA
22960-2808
US

IV. Provider business mailing address

13198 JAMES MADISON HWY
ORANGE VA
22960-2808
US

V. Phone/Fax

Practice location:
  • Phone: 540-672-3010
  • Fax:
Mailing address:
  • Phone: 540-672-3010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101058953
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: